血液科患者医院感染护理管理探讨

Nursing measures for control of nosocomial infections in patients of department of hematology

目的分析血液科患者医院感染的相关因素,并针对感染危险因素提出相应的护理措施。方法回顾性分析医院血液科2011年2月-2013年2月收治的血液科患者临床资料482例,统计分析入选患者感染情况及其感染相关因素;根据患者感染情况分为感染组和非感染组,进行对比分析;研究数据使用统计软件SPSS 13.0进行分析。结果 482例患者发生医院感染共106例,感染率21.99%;呼吸道感染52例、口腔感染11例、肛周感染19例、肠道感染12例、血液感染6例和泌尿道感染6例,分别占49.06%、10.38%、17.92%、11.32%、5.66%和5.66%;共分离鉴定102株病原菌,其中革兰阳性菌20株、革兰阴性菌71株、真菌11株,分别占19.61%、69.61%、10.78%;感染患者的年龄、侵入性操作、化疗次数、住院时间和预防应用抗菌药物等与非感染患者差异有统计学意义(P<0.01)。结论感染危险因素有患者的年龄、侵入性操作、化疗次数、住院时间和预防应用抗菌药物等;针对感染危险因素,积极开展感染防治护理措施,可降低或避免医院感染发生。

OBJECTIVE To explore the related factors for nosocomial infections in the patients of department of hematology and put forward corresponding nursing measures. METHODS Totally 482 patents, who were treated in the department of hematology from Feb 2011 to Feb 2013, were enrolled in the study, then the clinical data of the subjects were retrospectively analyzed, the incidence of infections and the related factors for infections were statistically analyzed; the subjects were divided into the infection group and the nonqnfection group according to the status of infections, and the comparative study was conducted; the obtained data were statistically analyzed with the use of SPSS 13.0 software. RESULTS Of the 482 patients enrolled, the nosocomial infections occurred in 106 cases with the infection rate of 21. 99%, including 52 （49.06%） cases of respiratory tract infections, 11 （10.38%） cases of oral infections, 19 （17.92%） cases of perianal infections, 12 （11.32%） cases of intestinal tract infections, 6 （5.66%） cases of bloodstream infections, and 6 （5.66%） cases of urinary tract infections. A total of 102 strains of pathogens have been isolated, among which there were 20 （19. 16%） strains of grampositive bacteria, 71 （69. 61%） strains of gram-negative bacteria, and 11 （10. 78%） strains of fungi. The difference in the age, invasive operation, frequency of chemotherapy, length of hospital stay, or prophylactic use of antibiotics between the infection group and the non-infection group was significant （P〈0.01）. CONCLUSION The age, invasive operation, frequency of chemotherapy, length of hospital stay, and prophylactic use of antibiot its are the risk factors for the infections; it is necessary to actively take nursing and prevention measures for the risk factors so as to reduce or prevent the incidence of nosocomial infections.